Random thoughts from a few cantankerous American physicians. All contributors are board certified. Various specialties are represented here. I do not know where this will lead but hope it will at least be an enjoyable read. All of the names mentioned in this blog are pseudonyms, the ages have been changed, and in half the cases the gender as well. All photographs are published with patient consent or are digitally altered to preserve anonymity. Trust us, we're doctors.

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Tuesday, September 25, 2007

From the CDC and ACEP. Ring true guys? I could not readily find the definitions of "immediate", "emergent" etc... but given that about 15% of patients seen in the ED are eventually admitted that makes me think that to get in the "urgent" category can't be that difficult. Your tax dollars at work.

When I was a resident, I actually heard a patient whose vagina was leaking green stuff after having a nasty infected penis shoved into it repeatedly say, regarding a GSW patient that we were coding, " I don't care if he is dying, I was here FIRST!" So I'm not sure what is urgent or emergent or just anoying.

thanks nurse k. we do have these categories in our ed but i, shame on me, do not look at the triage category but pick up each chart and look at the age, sex, chief complaint, and vital signs and make up my own mind.

on this chart then 6% of patients need a nurse and doctor at the bedside upon arrival for possible acute intervention and 10% might be sick enough to need an intervention soon. the rest, yawn, see ya soon.

1: Stuff that will or very probably will get considerably worse without professional help sooner than the pt can get in to see their regular doc; broken bones, any leak that can't be patched with a band-aid, MI, etc.

Eh, not your job to worry about triage. That's our job. Triage is stressful, man. If you don't catch something, it's YOUR ASS, or if you bring someone back quickly who is BS, then you get yelled at too. Or if you have 1 open bed and 5 out of 20 people in the lobby (category #3 or whatever, you have to bring #2s back whether there's a bed or not) who you think should be in that bed, you get yelled at by whomever because the other 4 waited too long.

You pretty much have a set of vitals and a couple of minutes to determine what you think a problem could be without benefit of an exam (we dont' do exams in triage) or diagnostic equipment of any sort.